The goal of the proposed research is to examine the association between early neglect, multiple caregiver transitions, and outcomes in middle childhood, as a step towards establishing more adequate models of early adversity effects within high-risk populations. The investigation involves recontacting a sample of families who participated in Healthy Families San Diego (HFSD) (N = 350), a longitudinal study that documented the prenatal experiences and first 3 years of life of a group of children at high risk for CWS involvement. Surveys have shown that, compared with the general population, CWS children have disproportionately high rates of behavioral and emotional problems, academic failure, and substance abuse; however, the mechanisms underlying these disparities are poorly understood. 1 reason for this gap in the literature is that prospective longitudinal samples of families at risk to become involved with the CWS are difficult to identify, recruit, and retain. As such, the HFSD sample is unusual in a number of respects. First, because the sample was recruited at the time of the child's birth, involvement in the study predates child maltreatment or involvement with CWS services. Second, 4 waves of prospective longitudinal data have already been collected, at birth and at 12, 24, and 36 months. Third, recruitment/retention rates were high in the original study, and recently gathered feasibility data from original HFSD participants suggests high rates of continued willingness to participate. Thus the HFSD sample has considerable potential to provide new information about underlying mechanisms of risk. We propose to conduct 2 additional waves of multiagent multimethod data collection across a broad range of domains of child and family functioning, when the children are 8-9 years old and 10-11 years old. The completed data set will allow us to examine direct effects of early neglect and caregiver transitions on a specific set of outcomes across 6 domains though middle childhood, including: (a) psychosocial adjustment; (b) substance use; (c) school outcomes; (d) peer relations; (e) CWS/juvenile justice system involvement; and (f) service utilization. In addition, we will test for moderator effects within a group of child and family contextual variables that include prenatal stress, neonatal health and early cognitive functioning, maternal depression and substance use, domestic violence, child gender, and onset of puberty. Finally, we will examine whether the effects of neglect/caregiver transitions are mediated through parenting practices in middle childhood and alterations in stress regulatory neural systems.